Ad Audit: Message Sacrifices Truth About Health Bills And Medicare

SUMMARY: A conservative advocacy group uses testimony from sympathetic older Americans to warn that a health care overhaul would impair Medicare, the government health care program for the elderly. The ad says older Americans should be shielded from spending cuts because of their great sacrifices for the country. But it’s truth that’s sacrificed here: the ad exaggerates the impact of proposed Medicare cuts and ignores some improvements in Medicare benefits included in the main Democratic bills before Congress.

BACKGROUND: The 60 Plus Association, a nonprofit advocacy group that bills itself as a conservative counterweight to AARP, favors lower taxes and less government. The group says it is has purchased $2 million in airtime in eight states that are homes to key senators: Alaska, Arkansas, Connecticut, Louisiana, Maine, Nebraska, North Dakota and South Dakota. The ads come in 30-second and 60-second versions.

VISUALS AND AUDIO (60-second version): As an American flag flutters, a narrator declares: “Seniors have sacrificed.” A succession of elderly men and women address the viewers while in front of historic footage: Depression-era bread lines, war scenes, battlefield grave sites and family scenes.

The people on the ad complete each others’ sentences: “We survived the Great Depression. And landed at Normandy on D-Day. We raised strong families and protected our freedoms in a dangerous world. We’ve been called the Greatest Generation, but we were only doing our duty. We sacrificed because we love our country, and all we’ve ever asked was to enjoy our retirement and receive the health care we have earned.”

The music becomes gloomier, as an image of the U.S. Capitol appears, followed by those of an anguished person in a hospital waiting room and of doctors and patients. “But now, Washington wants to cut up to $500 billion from Medicare to help pay for a plan that could lead to a government takeover of our health care and could withhold treatment in potentially life-saving drugs,” the people continue. “Don’t make us pay for health care reform by cutting Medicare. Call your senators and ask them: Haven’t America’s seniors sacrificed enough?”

The narrator concludes: “Don’t pay for health care reform on the backs of our seniors.” The screen shows photos and telephone numbers of the relevant senators.

POLITICS: The ad is part of a broader effort to increase concerns among older Americans about pending health care legislation. The insurance industry’s main lobbying group, America’s Health Insurance Plans, made a similar argument in ads last month. Both AHIP and 60 Plus are upset about proposals to create government-run insurance that would compete with private companies in selling coverage to people under age 65. Since many surveys show substantial support for the public option, however, the opponents are focusing on something else: The bills’ potential impact on the popular Medicare program.

ACCURACY: The health bills would reduce Medicare spending, but it’s highly unlikely medical care for the elderly would suffer, many health analysts say. “This ad is clearly intended to frighten people with a great deal of misinformation,” says Judith Stein, executive director of the Center for Medicare Advocacy, a Connecticut-based nonprofit that helps people secure Medicare benefits.

Under the Senate Finance Committee bill, Medicare spending, on net, would be $379 billion less over a decade, or about 5 percent of program expenditures, than under current law. In both that bill and the House proposal, a big chunk of the cuts would involve Medicare Advantage plans that are run by private insurers and often provide additional benefits beyond what traditional fee-for-service Medicare offers. The Finance bill targets Medicare Advantage for $117 billion in cutbacks over a decade; the House bill, $170 billion, according to the Congressional Budget Office.

Congress is eyeing Medicare Advantage plans largely because they spend an average of about 14 percent more on their members than traditional Medicare spends on its beneficiaries. If the cuts are enacted, the number of Medicare Advantage plans might decline. In addition, those that survive might pare back some of the extra benefits they offer, such as low or zero monthly premiums, dental care and free gym memberships. But no one would be denied basic Medicare benefits.

On the other hand, not all the proposed reductions would be painless  especially for the providers who would bear the brunt of other Medicare cuts. Overall, though, the cuts would be substantially less than the reductions approved by Congress in 1997 to balance the federal budget deficit, according to Tricia Neuman, a Medicare expert at the Kaiser Family Foundation. (KHN is a part of the foundation.) Congress ended up restoring some of that money a few years later. Lawmakers were worried some of the reductions, including those for skilled nursing facilities, were too severe. “It’s hard to anticipate changes in the health care system,” Neuman says. “Ongoing tweaks may be necessary.”

The ad’s warning about the rationing of “potentially life-saving drugs” lacks support. The 60 Plus Association tries to back up this claim by citing a few news stories about patients in England and Canada denied drugs by government insurers. But far from restricting access to drugs, “ironically, there are enhancements to the Medicare drug benefits” in the health overhaul bills, says Paul Ginsburg, president of the Center for Studying Health System Change, a Washington research group.

The bills being debated would eliminate co-payments for preventive services. In addition, the House bill would provide a 50 percent discount on brand-name drugs purchased when beneficiaries hit the coverage gap known as the “doughnut hole,” and it would gradually eliminate the gap. The Senate Finance bill would not close the doughnut hole, but it would provide the discount, which was negotiated with the Obama administration and the pharmaceutical lobby earlier this year. The House bill also would require Medicare to cover immunosuppressive drugs for as long as kidney transplant recipients need them, rather than for the current 36 months.

Overall the ad’s argument is built on a logical inconsistency: It raises the specter of “government-run health care” to increase concerns among both young and old. But at the same time it extols Medicare  which is government-run health care for people 65 and older.